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Computers in Medicine

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Some doctors think their office computers are as important to their practice as a stethoscope

Doctors with computers in their offices can have immediate access to a patient's medical history, current problems, and medications. They also can access the latest information on drug interactions and approaches to certain medical conditions, and they are able to plot a patient's blood pressure or cholesterol profile on a regular basis. What's more, they can automatically receive automated reminders that a patient is due for another kidney function test or mammogram.

Rather than take away time from patients, computers allow doctors to interact with their patients in a more comprehensive way, notes Helen Burstin, M.D., in a recent commentary. Dr. Burstin is Director of the Center for Primary Care Research at the Agency for Healthcare Research and Quality.

Before coming to AHRQ in January 2000, Dr. Burstin worked in a highly computerized environment of an academic health center, and then she worked in a minimally funded inner-city clinic that lacked computers. She concluded from these two experiences that use of computers helped her to be a better doctor. When she had access to a computer, she was able to chart and show to patients their medical progress or decline. And, when patients also had computers and Internet access, she could receive and send them E-mail messages about laboratory findings, medication refills, and tests needed.

Dr. Burstin found that the computer in many ways brought her closer to her patients. Often, patients viewed their lab tests, HIV virus counts, and cholesterol reports on the computer screen with her. Some non-English-speaking patients found ways to E-mail her questions or requests, either through a public library terminal or through friends with computers. As a doctor at the computerized medical center, she did not have to pour through pages of medical charts to find a patient's current medications, allergies, or findings from recent tests. In contrast, at the inner-city clinic, she had to consult out-of-date medication references and was not able to quickly access the latest research to confirm her own diagnoses or treatment decisions. Dr. Burstin cites the importance of finding ways to bridge the digital divide between these two worlds—medical care with and without computers—as a giant step forward toward improved health care quality.

See "Traversing the digital divide: On doctoring with and without computers," by Dr. Burstin, in the November 2000 Health Affairs 19(6), pp. 245-249.

Reprints (AHRQ Publication No. 01-R023) are available from the AHRQ Publications Clearinghouse.

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